Ancient times and the beginning of the quest
Globally, the history of hemotransfusiology is conventionally divided into three major eras. The first period covers a colossal timeframe: from antiquity to 1628. Mentions of the significance of blood can be found in the works of Celsus, Pliny, and even in Homer's epic poetry.
Several millennia BC, the healers of Ancient Egypt were already making tentative attempts to transfuse blood from healthy people to the sick. Naturally, in the absence of the slightest understanding of immunology and compatibility, these manipulations often ended in tragedy. The use of animal blood, especially of lambs, was widely practiced. It was infused into exhausted patients and the elderly. The rationale for this method was based not on physiology, but on the philosophy of that time: it was believed that animals were completely free from human vices, excesses, and destructive passions, which meant their life juices were pure and healing.
Empirical stage: trial and error method (1628–1901)
The second period started with a momentous event — William Harvey's discovery of the laws of blood circulation. The technical equipment of surgeons during that era remained primitive. The direct "vein-to-vein" method using silver tubes was applied, as well as the conventional syringe method. Dosage was calculated literally "by eye": the volume of blood transfused into the patient was determined by how much weight the donor animal had lost.
The year 1666 marked a milestone when French physician Jean Denis performed the first documented hemotransfusion in a human, which, unfortunately, proved unsuccessful. Physicians accumulated knowledge exclusively through empirical experience. It was during this time span that the classic signs of post-transfusion complications were first described: sudden patient anxiety, severe skin hyperemia, intense chills, and muscle tremors. By 1875, global medical statistics had accumulated data on 347 cases of human blood transfusion and 129 procedures using animal blood.
Scientific breakthrough and the modern period
The third period, which continues to this day, began in 1901. Austrian immunologist Karl Landsteiner formulated the law of isohemagglutination and discovered the isoagglutination properties of erythrocytes, identifying the first three blood groups. This discovery changed surgery forever, turning transfusion from a lottery into an exact science.
- 1907: Jan Janský supplemented the system by identifying the IV blood group.
- 1940: K. Landsteiner, together with A.S. Wiener, made another epoch-making discovery — they detected the Rhesus factor (Rh-factor).
Thanks to these achievements, hemotransfusion became safe and widespread.
Establishment of the blood service in Russia and the USSR
Russian medicine made a huge contribution to the development of the method. In 1832, St. Petersburg physician G. Wolf performed the first successful transfusion in Russia on a female patient with severe blood loss. I.V. Buyalsky (1845) persistently pointed out the giant prospects of the procedure in emergency surgery. A huge role was played by the fundamental work of A.M. Filomafitsky (1847) "Treatise on Blood Transfusion as the Only Means in Many Cases to Save Fading Life", which detailed the indications, methods, and putative mechanism of action.
In the early period (until the end of the 19th century), only 60 procedures were performed in the country, 22 of which were carried out by the outstanding surgeon S.P. Kolomnin.
The true heyday of transfusiology occurred during the Soviet era:
- 1921 — systematic scientific and practical application of the method began thanks to the work of V.N. Shamov.
- 1926 — the world's first specialized Blood Transfusion Institute was opened in Moscow.
- 1930–1931 — similar institutes started operating in Kharkov and Leningrad, and the formation of a network of regional stations began.
A special milestone was the work of V.N. Shamov and S.S. Yudin, who were the first in the world to develop and successfully introduce the transfusion of cadaveric blood into clinical practice. Today, transfusiology is a completely independent, complex medical specialty.
Briefly: answers to topical questions
Through what physiological mechanism does cadaveric blood, the transfusion method of which was introduced by Shamov and Yudin, maintain a liquid state?
Cadaveric blood maintains a liquid state and does not clot due to the natural process of fibrinolysis. Within 1–4 hours after sudden death, fibrin precipitation occurs, as a result of which the blood becomes defibrinated. This physiological feature was utilized by the authors of the method, V.N. Shamov and S.S. Yudin, for blood collection from corpses of practically healthy individuals. Collection is carried out by gravity from veins no later than 6 hours after death.
What modern blood components are used in surgery instead of whole blood transfusion?
In modern surgery, instead of whole blood, component therapy is used, providing a targeted impact on the pathology. The main components used:
- Packed red blood cells (Erythrocyte mass) — used for anemia, blood loss, bleeding, hypovolemia, and hemoglobin deficiency.
- Packed white blood cells (Leukocyte mass) — indicated for leukopenia, agranulocytosis, and immunodeficiency states.
- Packed platelets (Platelet mass) — used to treat thrombocytopenia.
- Plasma, albumin, protein — transfused for hypodysproteinemia, coagulation disorders, circulating blood volume deficiency, and intoxications.
What mandatory individual compatibility tests are performed immediately before hemotransfusion?
Immediately before hemotransfusion at the patient's bedside, a set of mandatory individual compatibility tests is performed. This list includes:
- Group compatibility test — performed after determining the blood group of the donor and recipient.
- Rh-factor compatibility test — performed after determining the Rhesus blood type.
- Biological test — carried out at the very beginning of the transfusion (the first doses of blood are administered slowly to assess the body's reaction).
To remember the discoverers: Landsteiner found the Face of the blood (main groups), and Janský added Clarity (the fourth group).
Class and exam questions
Why were people in ancient times transfused with lamb's blood?
Physicians of that time believed that animals were not subject to human vices, excesses, and passions, and therefore their blood possessed healing properties.
What event separates the first and second periods of the history of hemotransfusion?
The discovery of the circulatory system by the English physician William Harvey in 1628.
What is Karl Landsteiner's main contribution?
In 1901, he discovered the law of isohemagglutination and the first three blood groups, and in 1940, together with Wiener, he identified the Rhesus factor.
What unique technique was introduced by Soviet surgeons Shamov and Yudin?
They developed the theoretical foundations and introduced the cadaveric blood transfusion method into clinical practice.
What else to study on this topic
- Pathophysiology of post-transfusion shock and empirical descriptions of complications.
- Features of the transfusion technique using silver tubes in the 17th–19th centuries.
- Laws of isohemagglutination and the biochemical properties of agglutinogens and agglutinins.
- Indications and contraindications for blood transfusion according to A.M. Filomafitsky's treatise.
- Organization of the work of the first blood transfusion institutes in the USSR.
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Other topics in the section "CHAPTER 6. BLOOD TRANSFUSION"
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